NPIMap

Organization Active NPI

Millport Family Practice Clinic, LLC

  • Rural Health Clinic/Center
  • Millport, AL
National Provider Identifier
1902984032
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MILLPORT FAMILY PRACTICE CLINIC, LLC
Practice address
13530 Highway 96
Millport, AL 35576-2522
Phone
(205) 662-5784
NPI assigned
Nov 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Robert Enoch SwansonNPI 1508851486
Title
Managing Partner
Phone
(205) 662-5784

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

13530 Highway 96
Millport, AL 35576-2522

Mailing address

13530 Highway 96
Millport, AL 35576-2522
Phone (205) 662-5784

National Provider Directory

National Provider Directory

Locations

13530 Highway 96
Millport, AL 35576
Phone (205) 662-3207

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902984032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13530 HIGHWAY 96",
            "city": "MILLPORT",
            "state": "AL",
            "postal_code": "355762522",
            "telephone_number": "205-662-5784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13530 HIGHWAY 96",
            "city": "MILLPORT",
            "state": "AL",
            "postal_code": "355762522",
            "telephone_number": "205-662-5784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLPORT FAMILY PRACTICE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ENOCH",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "205-662-5784",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millport, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.